Finding an Orthopedic Doctor for Knee Pain in Tempe Arizona

By  aenriquez  published  September 26, 2017

If you have chronic knee pain, you should see an orthopedic doctor. The decision to undergo knee replacement is a major step toward reclaiming an active lifestyle. However, your knee pain may be treated without surgery. A knee doctor in Tempe Arizona can help you decide which treatment is best for you. Finding the right orthopedic surgeon can mean that you reduce or eliminate knee pain from your life.

Find an Orthopedic SurgeonAsk Your Current Clinicians

When considering an orthopedic doctor for knee pain, you should check with your primary care physician for a list of surgeons who specialize in knee replacement and chronic knee pain. Be sure to ask why the doctor recommends each specialist. You can also check with physical therapists, nurses, and other healthcare workers.

Check with Friends and Acquaintances

Ask friends, family members, and acquaintances who they recommend for the treatment of knee pain. When you make inquiries, ask why these people like the orthopedic knee doctor and find out what treatment options exist.

Insurance Coverage

When choosing a knee doctor in Tempe Arizona, ask your insurance provider who can help you. The insurance company will tell you who is in your plan, who is out of network, and who has a good reputation.

Evaluate the Surgeon’s Credentials

When looking in Tempe Arizona for an orthopedic doctor, spend some time reviewing the doctor’s background, education, training, and degrees. Find out if the doctor is board-certified and by what association.

Check on the Orthopedic Doctor’s Experience Level

If you are considering surgery or interventional procedures, as about the doctor’s experience. What surgeries has he performed? What is his statistics? Has he had good results with non-invasive procedures? Are other patients satisfied? These are things to consider when looking for a knee doctor.

Implant Training/Technology

Orthopedic doctors should have special technical training and education to include implant techniques. The doctor who specializes in knee procedures gains important training through the use of new devices, current surgical approaches, and new technologies. Hospitals sometimes prefer certain manufacturers and devices, so check the facilities in Tempe Arizona when choosing an orthopedic doctor for knee pain.

Experience with High-Risk Cases

Inquire with the orthopedic surgeon regarding experience with high-risk cases of knee pain. Discuss your complete medical history with the surgeon before undergoing any procedures. Be sure he can handle your unique problems and deal with potential complications that can arise.

Meet with the Orthopedic Surgeon

Before choosing a doctor to treat your knee pain, request a consultation with the specialist. Discuss your knee pain, ask questions, solicit an opinion, and review your goals. This gives you a chance to make your decision about treatment. Before your appointment, make sure you understand your pain level and knee history. It is helpful for you to prepare a set of questions to ask the specialist. During your consultation, explain your pain and address your concerns. Ask the knee doctor about his success rate, inquire about his experience in dealing with chronic knee conditions, and bring all your medications.

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Non-Surgical Scoliosis Treatment

By  aenriquez  published  September 19, 2017

Scoliosis Check for the Curvature of the spineAlthough researchers have not determined the specific causes of scoliosis, treatment with braces and surgery have remained the same for more than a century. Scoliosis is a very complex condition involving bone, muscles, ligaments and other body systems, and most cases are idiopathic, meaning there is no known cause. The traditional treatments have fallen short in treating all aspects, and these treatments have repercussions of their own. Amazingly, some doctors are even still using an outdated two-dimensional tool called the Cobb angle to measure spinal curvature. New 3-D methods like MRI or posturography are much more reliable.

Surprisingly, surgery is not even necessary in most cases of scoliosis. Very rarely is scoliosis a life-threatening condition; this is only seen in young children with severe spine deformation that interferes with the lungs and heart. Scoliosis sufferers sometimes have back pain, but beyond that, there are no physical consequences and adults with untreated scoliosis are usually very high-functioning. The surgery is largely done for cosmetic reasons alone.

In teenagers, surgeons typically recommend surgery with curvature over 40 degrees. Teens are the largest surgical population for this surgery, and teens as young as 14 have had the surgery, before they’ve stopped growing; that can cause serious consequences down the road. Surgery is often presented as an immediate need, and surgeons reassure parents that the surgery is so much better than it used to be.

But every surgery is invasive, creating a great risk of infection and other complications. Spinal fusion of vertebrae should only be a last-resort option.

The good news is that there is now a much better, non-invasive scoliosis treatment that involves teaching the brain to hold the spine in a straighter position. The treatment is effective for both children and adults with scoliosis.

It is a neuromuscular training technique that treats not only the bone in the spine, but also the corresponding supporting muscles, tendons and ligaments. Scoliosis’ cause is unknown, but research studies have shown that lack of communication between the postural control center in the brain and the body does make it worse.

Basically, there should be signals that the body posture isn’t balanced, but those signals never occur. This non-surgical approach uses exercises to retrain the brain to tell the body about postural imbalances. Over time, muscles are less resistant to the spine, and the body and brain learn how to hold the spine straight.

The method has been shown to reduce or stop pain, stop the progression of scoliosis and reduce the abnormal curvature of the spine. The technique is effective in both adults and children. Ideally, in children, if the treatment is started before a child has a 25-degree curve, that child will never have to have surgery.

The technique is non-surgical, and back braces are not required. There are no sports or activity restrictions either.

Contact us to learn about this technique before you try surgery. Although scoliosis surgery has become less invasive, it is nevertheless a surgery, and that comes with inherent risks. The surgeries have a high failure rate involving implant failure, and surgery often does not eliminate back pain or offer improvements like better breathing function. Many suffer nerve damage, infection and chronic pain as a result of the surgery, only to find they have no improvement in quality of life. And don’t forget about the scar that runs the entire length of the back.

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3 Phases of Post-Surgery Healing

By  admin6  published  September 19, 2017

Rotator cuff tears are commonly encountered shoulder problems and often present with non-specific pain. A skilled and experienced orthopedic surgeon, such as Dr. Sumit Dewanjee at FXRX in Phoenix, has special expertise in the diagnosis and management of rotator cuff injuries with minimally invasive surgery.

If you have been through surgery for tendon repair, you should know that your shoulder goes through 3 phases of healing before it recovers fully.

Inflammatory Phase

The inflammatory phase occurs during the first week after surgery. The platelets facilitate clotting to stop any bleeding. Chemicals are sent throughout the body to attract inflammatory cells to the site of surgery.

Proliferative Phase

The proliferative phase of tendon healing is also the new cell formation phase from the first week to 2-3 weeks after surgery. The inflammatory cells produce scar tissue and the original clot is replaced with new blood vessels. This scar tissue becomes the building block for more permanent repair tissue that would form in the next phase.

Maturation Phase

The maturation and remodeling phase occurs about 3 weeks after your surgery. The scar tissue is starting to get replaced by more mature, repair tissue. This phase may last at least 12 weeks but may go up to 26 weeks.

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Swedish Study Regarding Use of Brace for Scoliosis

By  aenriquez  published  September 13, 2017

A study was conducted whereby Swedish patients had been involved in an SRS brace study had been invited for a long term follow up. The objective of this study had been the investigation of the rate of scoliosis surgery and its link to the progression of curves from baseline, as well as after maturity. In this study, brace treatment was concluded to be superior to electrical muscle stimulation. It was found to be superior to observation alone, as in the original brace study. There have been very few other studies that have been able to show that brace treatment is indeed effective in the treatment of scoliosis.

Scoliosis Bracing TechnologyThe method used in this bracing study involved both the Boston brace treatment (this was applied to 41 patients in Malmö) and observation alone as a treatment method (applied to 65 patients in Göteborg). The total number of patients was 106, out of which only 87% attended the follow-up in which radiography and chart review was included. The radiographs were all measured for curve size using the Cobb method. This was done by an unbiased examiner. Patients who had undergone the surgery after maturity were identified from the mandatory national database.

The mean age at the first follow-up time was 16 years, and 32 years was the mean age at the second follow-up. Both treatment groups were shown to have equal curve size at the inclusion. The patients who were treated with a brace from the start, had their curve size reduce by 6 degrees during the course of the treatment. The curve size returned to the same level over the follow-up period.

The primarily braced patients underwent surgery. In the observation alone group, 20% due to progression were braced during adolescence. The other 10% underwent surgery, and the remaining 70% of the patients were observed alone, with an increased by 6 degrees from inclusion till now. Surgery after maturity was not performed on any of the patients, and progression was related to premenarchal status.

The conclusion of the study showed that the moderate or smaller size curves of patients with adolescent idiopathic scoliosis did not show deterioration beyond their original curve size in this 16-year follow up. Patients treated with a brace did not need surgery; however, 6 patients, which was a 10% of the total in the observation group, needed surgery during their adolescence. Thus, it was concluded that curve progression was related to immaturity.

Resources
Parent SNewton PO, & Wenger DR.
Danielsson AJHasserius ROhlin A, et al.
Richards BS, Bernstein RM, D’Amato CR, et al. 

 

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Corticosteroid Shoulder Injection for Shoulder Pain

By  aenriquez  published  September 6, 2017

Shoulder Injection - Posterior ApproachShoulder pain affects thousands of U.S. adults. According to clinical studies, shoulder pain affects 4% of the general population, and 1% of people age 45 years and older consult their family doctor each year with a new presentation of shoulder pain. Many individuals suffer from mild-to-moderate osteoarthritis of the shoulder. While pain medicine and physical therapy may work for some, others suffer with long-term, recurring shoulder discomfort. A shoulder injection may be necessary to relieve the pain associated with many types of shoulder arthritis.

If pain medication does not provide relief, the pain management specialist may recommend an injection of medicine directly into the shoulder joint. Orthopedic and rheumatologic specialists often use ultrasound guidance to assure the medication goes directly into the joint. Injections for shoulder pain are safe and effective and offer longer pain relief than conservative measures.

Corticosteroid Injection for Shoulder Pain

Many shoulder conditions produce an inflammatory effect that leads to pain. Corticosteroids are anti-inflammatory medications that are injected into the shoulder joint. A corticosteroid will reduce inflammation, which is the body’s immune response. Inflammation leads to swelling, redness, warmth, and pain. Before the injection, the doctor will administer an anesthetic, either locally or into the skin. After numbing the area, the corticosteroid agent is injected directly into the joint.

The corticosteroid solution starts to work after 2-3 days. An anesthetic, such as bupivacaine or lidocaine, is added into the solution to offer immediate pain relief. For some people, a corticosteroid shoulder injection for pain can offer several months of pain relief. Doctors recommend no more than 3 corticosteroid injections into the shoulder joint during a time-span of 3-5 years.

Hyaluronic Acid Shoulder Injection

The shoulder joint contains a gel-like lubricating substance known as synovial fluid. Over time, and with age, the joint becomes depleted of this fluid. Synovial fluid cushions and lubricates the joint. Hyaluronic acid is a component of this fluid. A medication produced in the laboratory, hyaluronic acid, is now used to replace this lost fluid. Hyaluronic acid injections can increase the joint fluid’s viscosity, improving the gliding motion, and relieving symptoms of arthritis.

With chronic shoulder pain, the pain management specialist may recommend an injection of hyaluronic acid. The injection involves placing the medication into the joint under ultrasound guidance. After the injection, the joint may be tender for 24-76 hours, and maximum effects are noticed in 2-3 weeks. One hyaluronic acid shoulder joint injection can provide beneficial for up to 12 months.

Platelet-Rich Plasma for Chronic Shoulder Pain

Platelet-rich plasma (PRP) is a solution of the patient’s own blood components that is injected into a joint. The patient first has his/her blood drawn. The nurse processes the blood in the laboratory, where the platelets are separated from other blood components. The platelet solution is then injected into the painful shoulder joint using x-ray (real-time) guidance. For shoulder pain, the results are usually felt within 2 weeks, and benefits may last for up to a year.

In a recent study involving joint degeneration from osteoarthritis, researchers evaluated the safety and effectiveness of PRP joint injections. They found that PRP injections were beneficial for people with mild osteoarthritis, but only were somewhat effective for moderate arthritis. Because the patient goes through a mild exacerbation period after the injection, the shoulder joint may be tender for up to a week.

Resources

Jang SJ, Kim JD, and Cha SS (2013). Platelet-rich plasma injections as an effective treatment for early osteoarthritis. Eur J of Orth Surg & Traum, 23(5), 573-580.

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Signs you are suffering from a Torn Meniscus

By  admin6  published  August 30, 2017

The knee joint includes several important components that allow movement involved in getting up, walking, pivoting and many more movements that your knee helps you make throughout the day. Often taken for granted, these movements can become a challenge if the meniscus is torn.

The menisci are two small discs of cartilage that lie between the thigh bone and the shin bone to even out the pressure in the knee while standing or walking.

A meniscus tear can be caused by an injury or day-to-day wear and tear. Meniscus tears near the outer edge have a better chance of healing.

What are the common symptoms of torn meniscus?

The most common symptoms of a meniscus tear include:

  • Pain over the inner half of the knee that worsens with pivoting or deep squatting
  • Swelling on the upper and outer part of the knee
  • Motion, such as deep knee bending an pivoting is often limited
  • A feeling of instability or the knee giving out
  • Locking, catching or popping of the knee

How would I know if I have a torn meniscus?

Simply having knee pain does not indicate a torn meniscus. If some of the symptoms listed above have continued for more than a week, it may be a sign of a torn meniscus. An orthopedic surgeon is the best person to evaluate the pain and other symptoms.

To learn more or to consult the best orthopedic surgeon in Phoenix, AZ, Dr. Sumit Dewanjee, call FXRX Inc. at 480-449-3979. As a leading orthopedic surgeon who is an expert in arthritis and fracture treatment in Phoenix, Dr. Dewanjee has performed hundreds of successful knee and shoulder arthroscopies and other treatments.

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Orthopedic Bracing and Adolescent Idiopathic Scoliosis

By  aenriquez  published  August 24, 2017

A three-dimensional deformity of the spine is referred to as adolescent idiopathic scoliosis. Different research teams have made great efforts to actively get to the etiology of scoliosis, but it still remains unclear. Treatment of this condition requires a sound clinical judgment and also a thorough understanding of the natural history of this disorder.

Bracing can present a challenge to the orthopedic surgeon in the evaluation of adolescent idiopathic scoliosis, an institution of conservative treatment, and the monitoring stages. Most patients, however, only require clinical monitoring. The review of the patient’s history, as well as a thorough physical examination, can help make for an easier diagnosis and help establish the risk for the progression of this condition as well.

 

idiopathic scoliosisDiagnosing Adolescent Idiopathic Scoliosis

The factors that can help the orthopedic surgeon assess the likelihood of the progression adolescent idiopathic scoliosis are gender, curve location, skeletal maturity, growth velocity, and the magnitude. Bracing has been identified as being the only nonsurgical measure currently proven to be effective in helping to halt the progression of scoliosis. Other types of conservative treatments do not have any effect in modifying the natural history of this condition. The results of bracing have a direct relation to being compliant with the brace treatment itself, optimal results can only be achieved with cooperation from the patient and from full support from their families.

Between 2% to 4% of adolescents are affected by adolescent idiopathic scoliosis, which is the most common form of scoliosis. In both male and females, the incidence of scoliosis is the same. In females, however, the risk of curve progression is ten-fold greater. Most young people with the condition will not develop clinical symptoms. However, scoliosis can progress onto rib deformity and respiratory problems, causing cosmetic problems which can be significant in the long term and may also be a cause of emotional distress to some of the patients.

 

Scoliosis Screenings

Scoliosis screenings had been a routine part of the physical examinations for adolescents for decades. However, this was not recommended by the U.S Preventive Services Task Force and American Academy of Family Physicians, as the harm from the screening can outweigh the benefits by exposing many of the low-risk adolescents to radiographs and referrals which are unnecessary.

The Scoliosis Research Society, however, declares that the potential benefits resulting from the detection of scoliosis early will justify the screening programs. They further add that greater care should be exercised when making the decision as to which of the patients detected with positive screening results, will be in need of further evaluation.

Primary care physicians have the main duty, which can be defined by identifying patients who seem to be at a risk of developing further problems as a result of scoliosis. Further care has to be taken by the primary care physicians, so as not to overtest or over-refer the patients who are not likely to develop any further problems. The Adam’s forward bend test and a scoliometer measurement are two types of physical examinations which can provide a guide to the judicious use of radiologic testing for orthopedic referrals and Conn angle measurement. The options that can be employed for treatment of the same are surgery, braces, and observation.

 

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Rehab Exercises after Total Hip Replacement

By  aenriquez  published  August 16, 2017

After a total hip replacement (THR), you must do hip and leg-strengthening exercises every day. These exercises are used to increase muscle flexibility, improve hip strength, and promote healing by increasing blood flow.

hip_fracture1

Exercise Program

A regular exercise program is used to strengthen weak leg and hip muscles. Your success with rehabilitation relies on your willingness to follow the exercise program developed by your physical therapist. You should perform these exercises 2-3 times each day after surgery. Each exercise must be done 10 times, starting out, and you gradually increase the repetitions by 5 times each week until you reach 20 repetitions. Your schedule will be:

  • Week 1 – 10 repetitions
  • Week 2 – 15 repetitions
  • Week 3 – 20 repetitions

Thigh Squeezes (Quadriceps)

The quadriceps muscles are located at the front aspect of the thigh. These muscles support and control the hip joint.

  • Lie on back with legs straight out.
  • Contract the muscles at the front of the right thigh.
  • Keep the leg straight during contraction with knee pressing down.
  • Hold for 5 seconds and release.
  • Repeat with another leg.

Buttock Squeezes (Glutes)

The gluteus muscles are located in the buttock region. These muscles support and control the hip joints.

  • Lie on back with legs straight out.
  • Squeeze the buttocks to contract the glutes.
  • Hold for 5 seconds and release.

Ankle Pumps

These exercises work the muscles of the lower leg to improve blood circulation and strength.

  • Lie on back with legs straight out.
  • Prop ankle up on a rolled blanket.
  • Flex foot and push heel away from the body.
  • Keep toes pointing up and toward the body.
  • Hold for 5 seconds.
  • Repeat with another leg.

Heel Slides (Quads and Glutes)

These exercises engage the gluteal muscles as well as the quadriceps muscles.

  • Lie on back with legs extended.
  • Flex new hip at the knee.
  • Bring the knee off the bed while sliding the foot along the bed.
  • Keep another leg straight.
  • Hold for 10 seconds.
  • Repeat with another leg.

Hip Abduction

Hip abduction exercises move the limb away from the body. Hip exercises can be done standing up with hands braced on the back of a chair. These exercises stabilize the pelvis and return gait (walk) to normal.

  • Lie on back with legs straight out.
  • Keep leg straight and toes pointed upward.
  • Slide the leg to the side moving from the center line of the body.
  • Move leg back to the center line, avoiding angling the leg inward.
  • Keep other leg extended and straight.
  • Repeat with another leg.

Knee Extensions

These exercises strengthen the quadriceps muscles and improve knee and hip flexibility.

  • Sit in a chair.
  • Raise the foot and extend the knee so the leg is straight.
  • Hold for 5 seconds.
  • Lower the foot back to the floor slowly.

Improve Balance

After you have improved strength, it’s time to work on improving balance.

  • Place a telephone book or solid object on the floor as a step.
  • Holding onto a counter or table, step forward and onto the object.
  • Slowly step back down.
  • Repeat with another leg.

Strength and Balance

  • Hold onto counter or table for support, and shift your weight onto the affected leg as you lift the other foot off the floor.
  • Stay level, avoiding leaning or tipping to one side.
  • Stay balanced on one leg for 20-30 seconds.
  • Lower the foot to the floor.
  • Repeat with another leg.
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Most Frequents questions that are asked to a knee surgeon

By  admin2  published  October 6, 2015

Have you ever suffered a knee injury? No, no, not the mere cuts and bruises but one which is deep and cannot be treated from the surface. Such injuries can be painful. In fact, most of you won’t be able to take the pain and gobble down painkillers in one go. But, that’s not the solution, right? If your injury is severe, it may lead to complications later on. So, why not go and see and knee surgeon before things get too complicated?

Taking an appointment with a knee surgeon is no big deal. But yes, finding the right one is. You have the internet. Search for the best knee surgeon in your area and shortlist few names. Then you can see their reputation on the web and get an idea how satisfied their patients are. Select the best one and make an appointment.

It is true that when you visit the chamber of the knee surgeon, you will have a lot of things going on in your mind like:

  • Is my condition pretty severe?
  • Will he want to operate?
  • Do I need a knee replacement surgery? And so on.

In the midst of so many things going on in your mind, you may forget some necessary questions like the cost of a knee surgery, its side effects, how long are you going to take the medicines and etc. do one thing. Write them out on a piece of paper. But yes, do not scribble it. Make a proper list like the one given below:

Questions to be asked to the knee surgeon:

  • What is the guarantee that my implant will be successful and it will not move from its position in future?

Yes, there are few real chances of that happening. You doctor, if he is a reputed one, will make sure that it doesn’t. He will be quite experienced enough to make the right cut at the right angle to insert the implant.

  • What will happen if in future the implant becomes loose?

If you have not noticed yet, doctors do not give a 100% guarantee on anything. But, they give their best to minimize the chances of such incidents as the one mentioned above. If you are aware that you have had a knee transplant, you will be careful for the rest of your life. And that much is required to keep the implant steady. Otherwise, you just have no risk if your doctor is an experienced surgeon.

  • What are the chances of getting an infection?

Knee surgical infection

There is almost no chance of getting an infection if you have chosen an experienced knee surgeon. This is because all surgical instruments are sterilized properly and you will be under the effect of antibiotics that prevent infection.

  • Is there any chance of nerve damage?
knee surgeon phoenix

Nerve damage

Yes, you may have heard about something like this. We all have. But the chances are really less if your doctor is experienced and knowledgeable about the whole thing. He will explain everything to you before you take any decision and less you are satisfied, he will continue answering your questions. After all it’s your knee, a very important contributor in your locomotion.

You can easily find an experienced knee surgeon in Phoenix, Arizona. Just take help of the internet and choose the most reputed one among the results. You will be in good hands for sure.

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How To Recover After Knee Arthroscopic

By  admin2  published  May 25, 2015

Knee Surgeons Phoenix AzArthroscopic surgery is a surgical process where the cartilage in the tendons in your joint are reviewed by a surgeon and repaired. The process begins with a small incision around your kneecap through which a small tube is placed. This tube contains a small camera. The camera is used to reach small areas of your joint in search for the affected region. The camera will show images of the inside of your kneecap to the surgeon on the video monitors inside of the operating room. This allows the Arizona orthopedic surgeon to review the inside of your joint in search for the damaged area.

Once the damaged area is located the knee specialist in Phoenix uses a camera for guidance while they make a secondary incision through which miniature surgical tools are inserted and used to fix the problem. The process of arthroscopic surgery offers significantly faster recovery times compared to open surgery and the incision spots are both quite small. Once this process is complete the Arizona orthopedic surgeon is able to stitch up the incision and work with you to create a recovery plan.

This is a surgical process recommended after you have attempted all other nonsurgical treatment options with no success. If you have exercised all nonsurgical options and your knee joint continues to remain in flames or damaged this surgical option may be your only resort. A doctor will review your medical history and evaluate your current medical health prior to recommending a surgeon. This knee specialist Phoenix will speak with you about the process and what will happen before, during, and after. You might have to get blood work and a regular checkup completed by your primary care physician in order to verify your health. You should also make sure that while speaking with the Arizona orthopedic surgeon you discuss any medications or herbal supplements that you are currently taking. In some cases you may be asked to stop taking these items two weeks before the surgery takes place.

What happens before the surgery?

Before the surgery takes place the hospital will contact you to speak with you about what is expected in terms of your arrival time, what items you should wear, and what items you should and should not drink and eat. All advice offered must be followed. Should you have any questions the hospital staff will be able to answer them.

A local nerve inhibitor will be applied to your knee joint in order to inhibit the nerves in the region which send pain signals to your brain. The area will become numb but you will still be awake. If you prefer to not be awake during the process you can opt for general anesthesia in addition to the local inhibitor. If you have both forms of anesthesia you will help offset the amount of pain that you feel after the surgical procedure is complete.

Your orthopedic surgeon in Phoenix AZ will likely give you a plan for physical therapy. It is imperative that these recommendations be followed as they will help you to retain flexibility and improve strength in the joint.

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